Dealing with emotion during patient care.

AJPV · May 15, 2011

Wow - this is a GREAT post. I'm also a nursing student & can't wait to read the replies. I agree - our curriculum also neglects this topic almost entirely.

su9032 · May 15, 2011

Those situations are so terribly difficult and heartbreaking. As a student, I went home and cried on several occasions after my peds clinicals. In pediatrics, we did have 1 lecture that focused specifically on end of life situations and terminally ill patients when dealing with the parents and siblings of a child or infant that is dying. There was chapter in out Maternal-Child text that was devoted to it which was well worth reading. Have you looked to see if this was addressed in your text?

Mary Hicks · May 15, 2011

I will have to look in the book but this issue was never addressed through the whole class. Peds is a place that most of the nursing students in my classes wants to go into and I feel for them because they have to realize that ending the life of a little infant is much harder than ending the life of an adult. It is ultimatly the parents decision to take the child off of life support but they are not the ones that are actually doing it. Will these new nurse's be able to handle this part? I know after working so many years in this field you get used to it(don't like these words) but it still pulls on the heart strings.

AJPV · May 15, 2011

I think the issue of coping with grief and emotional stressors of many kinds needs to be addressed in nursing education. Have you ever looked at the disciplinary actions listed by your state board? Half of them are for substance abuse. That might be a sign that there is a lack of healthy coping skills for the stress encountered in nursing.

AgentBeast, MSN, RN · May 15, 2011

Read books and such all you want, but there is no simple answer. Everyone deals with things differently.

tokmom, BSN, RN · May 15, 2011

I personally don't do ped for that reason. I have kids, so it would be too personal for me.

As for emotions, I try to check them at the door, but if there is a patient that I have taken care of many times that has passed, I have shed a few tears with the family. Why not? I'm human and I care. It doesn't stop me from still doing my job.

I once took care of an end stage cancer pt that was 36. She was in the midst of a divorce with a few kids. She spent weeks in the hospital and finally passed. When she went to surgery only to be told there was nothing they could do, I went into the bathroom and cried. I then fixed the make up and then went to take care of her, many times over.

Emotions are something that you eventually learn to control, but it's never easy when anyone dies.

RNperdiem, RN · May 15, 2011

Nurses are able to do something.

We can help relieve suffering, help people heal.

We cannot solve all problems, but we can give the best care possible.

I work in Trauma, and that involves a higher than average "tragedy" factor. Sometimes I float to Burns or Neurosurgery which have even sadder stories, so I know how it can be.

I try to put emotions into useful action to help my patients.

canesdukegirl, BSN, RN · May 15, 2011

OP, I think that it is perfectly fine to show SOME emotion. When you are taking care of a patient/family that is going through one of the most traumatic and difficult times in their lives, they appreciate and can relate to a nurse that shows empathy. Now I am not saying that you should sob in the corner and then have the family feel that they should comfort YOU (and I am sure that is not what you would do), but I am saying that it is not "taboo" to get choked up along with the patient/family during instances such as end of life scenarios.

I became a nurse BECAUSE my mother's hospice nurse showed such compassion for her and for us. She cried right along with us when the priest read the last rites. I was touched that she cared so much-and I was further impressed in her ability to be professional, strong, yet gentle enough to help us pick up the pieces immediately after her death.

In short, you must gauge the situation according to the "vibe" of the family. If they are stoic, then you must also be stoic. If they are free with their emotions, then you must walk the fine line of being professional and put-together while still showing compassion, much as my mother's nurse did. It is hard to learn this, but experience is truly the best teacher.

umcRN, BSN, RN · May 16, 2011

Interesting. I work in a NICU. As a student I worked as a tech on an adult cardiac step down and ICU. I had a MUCH harder time dealing with the neglected elderly whose family "wanted everything done".

Dealing with the loss of an infant is tough because you are losing a future life, whereas an adult/child, you are losing a past and present life. Any infant that is dying is not likely to have the greatest longterm outcomes/quality of life either, not always, but usually by that point they are pretty devastated...there has to be major organ damage for Docs to even consider discussing end of life usually

I had a primary baby recently for 4 months, she got sick instead of discharged as was being planned and died shortly after and very suddenly...let me tell you there wasn't a dry eye in that room, I sobbed through much of the bearevement cares, and through her funeral that I ended up going to. For her family I did whatever they wanted. I let them have time with her, me and mom gave her a warm bubble bath and dressed her, then mom and dad spent another hour or so with her. After they left we did all our routine bearevement stuff that you will find in a NICU, hand/foot prints and molds. Photos, clipping hair, gathering anything from the room that could be used as a reminder of her.

Like others have said, everyone deals with emotions in their own way, and everyone finds their "place" in nursing. I am actually about to change jobs to a pedi cardiac ICU, I am worried about how I will handle the death of an older child but I'll just have to find out when I get there.

Also...as a Nurse I have never "ended a life". I have been present and part of support being withdrawn but its life support, ventilators, pressors, sedation, heart/lung bypass, dialysis...yes without those things the patient wouldn't have a heartbeat but in withdrawing support we are allowing nature to take its course, I don't look at it as "killing" or ending that life...and there are times despite all the maximal support we can give, patients declare themselves, hearts will stop despite all the drugs you can give to restart it and by that point nature is taking its course

Mary Hicks · May 16, 2011

I find that very intersting when my daughter was dying the nurses showed no compassion. Though they did the normal things like you we received in the mail the hand and foot prints, the clipping of her hair, the clothing that she was in when we got to hold her for the first time. We received no sorry for your loss. She was 15 days old and lost her battle with her medical problems. Had it not been for my sister who was a RN I would have been lost when it came to making decisions about her care down to what kind of autopsy we wanted done. Glad to hear that other parents receive better breavement care than I did. I only hope that I can be the nurse that I was looking for that day in the NICU.

umcRN, BSN, RN · May 16, 2011

Sorry...apparently I have 1 more thing to say...

Sometimes it hurts me more to keep those "obviously terminal" patients alive because the parents don't want to believe it. Now I have never lost a child so I can't imagine the pain in that situation, but the measures used to keep some babies alive sometimes, it can be heartbreaking, to the point I don't want to even preform routine cares because I don't want to put the child through anymore pain but I have to do it anyways. Those ones are hard. :crying2: